• T1
• T2
• vertebrae
• ribs 1&2
• manubrium

• T3-T7
• ribs 3-7
• sternum

• T8-T10
• ribs 8-10

cervical: 35

kyphotic: 40

lumbar:45

1. wedge shaped IVD: taller anteriorly

2. wedge shaped vertebral bodies

3. facet joint orientation

4. muscular and CT tension

• give slightly under a load, functions as an arch

body allows spine to give and transfer some of compressive load to stretched CT and muscles of its many articulations

1. static postures and repetitive movement patterns: place excessive shear forces on spinal segments outside transitional regions

2. pregnancy: weight distribution coupled with stretch weakness induced in ab musculature frequently leads to alterations in spinal curvatures and increased shear force at associated vertebral segments

3. aging: leads to a loss of LBM and weakening of axial musculature which can lead to alterations in normal spinal curvature and increased shear force at associated vertebral segments

4. disease processes: alter normal spin curvatures: scoliosis, osteoporosis, obesity, ankylosing spondylosis can place significant shear forces on spinal segments outside transition regions, and change change volume/size of intrathracic/intraabdominal cavities and compromise organ function

1. mastoid process of temporal bone

2. anterior to S2

3. posterior to axis of rotation of hip

4. anterior to axis of rotation of knee

5. anterior to AOR of ankle

ideal posture allows compression forces due to gravity to help maintain intended curve shapes. The external torques due to gravity are maximal at each regions of the apex:

• c4-C5
• T6
• L3

• bump on midline of posterior aspect of occipital bone
• attachment site for ligamentum nuchae and medial portion of upper trap

• stretched out laterally from EOP to base of mastoid process of temporal bone
• trap and splenius capitus muscles attach here

• lies inferior to superior nuchal line
• extends laterally from midline of occiput
• semispinalis capitus attaches along here

articular process: nearly vertical, aligning apophyseal joints almost in frontal plane

super: face post

inferior: face anterior

• T1 has full costal facet superiorly which articulates entirely with head of first rib
• T1 has partial costal facet inferiorly which articulates with a portion of the head of the second rib

T11: has a complete costal facet on its body for articulation with the 11th rib

T12: has a complete costal facet on its body for articulation with the 12th rib

T11 & T12 transverse processes do not articulate with the neck of ribs 11&12

on lumbar vertebrae

short projects from posteiror aspect of each superior articular process and serve as attachment sites for multifidi

superior: mildly convace and face medial to posteromedial dependingon level in lumbar spine

inferior art facet: slightly convex and face lateral to anterolateral depending on level

• Anterior Longitudinal Ligament

• attach to anterior aspect of vertebral bodies from the basilar portion of the occipital bone to anterio aspect of sacrum
• narrow at cranial end and widens as it travels caudally
• strong ligament and its fibers blend with and reinforce the anterior aspect of the intervertebral disc
• similar to sling in that it limits excessive extension (lordosis) in the cervical and lumbar regions. vertebrae fall into/rest into the ligament

• lies in vertebral canal on posterior aspect of vertebral bodies from C1 to sacrum, just anterior to spinal cord
• blends with and reinforce that posterior central aspect of the intervertebral discs
• cranially the posterior longitudinal ligaments starts as a wide structure which narrows as it travels inferiorly

• originates on the anterior surface of the lamina & inserts on the posterior aspect of the lamina below
• ligament is thickest in the lumbar region, but exists throughout the vertebral column
• single segment level: passive tension in ligament limits flexion of one vertebrae on the other, in multi-segments sense as a whole this ligament limits spinal flexion
• lies posterior to spinal cord and can interact with spinal cord
• consider effect of loss of disc height and spine hyperextension on the itneraction between the ligamentum flavum
• yellow ligament: high content of yellow elastic CT

• runs from spinous process of superior vertebrae to spinous process of immediately inferior vertebrae
• found between C7-sacrum
• ligament limits spinal flexion

• superior to C7 the ligamentum nuchae is the extension of supraspinatus ligament
• attaches to the cervical spinous processes and the EOP
• ligamentum nuchae is an important midline structure to which a number of cervical muscles attach
• palpation of cervical spinous processes is complicated secondary to the presence of ligamentum

• lies deep to supraspinous ligament and like it runs from spinous process of the superior vertebrae to the spinous process of immediately inferior certebrae
• limits spinal flexion

• spans space between adjacent transverse processes
• ligament limits contralateral lateral flexion
• ligament exists through the entire spinal column, but to vary degrees. As we progress from the cervical to thoracic to lumbar spine the number of ligament fibers and their quality increases

interspinous

intertransverse

• broad firm sheet of CT which lies posterior to transverse ligament and runs from C2 to basilar part of occipital bone just anterior to forament magnum
• helps connect the axis with cranium and limits extremes of cervical flexion and extension

• originates and insterts on the atlas and lies entirely within the vertebral canal
• along with anterior arch of atlas it forms a ring through which dens projects
• spans vertebral canal it runs from inferomedial to superior articular facet of one side to the other
• region of the transverse ligament that crosses dens is carilage lined and helps to create the posterior synovial cavity of the articulation between the dens and atlas
• vitally important ligament for maintaining upper cervical stability

• tough fibrous cords that pass obliquely in superior and lateral direction from apex of dens to medial side of occipital condyles
• work to limit axial rotation of occiput and atlas relative to axis, as well as sidebending

costotransverse Ligament

long ligament that connects neck of rib to entire length of a correspinding transverse process

• strong ligament that attaches between the superior margin of the neck of one rib and the inferior margin of the transverse process of the vertebrae above

1. shock absorption

2. joins vertebrae and allows movement between vertebrae

3. allows free passage of nerve roots from spine

4. separates vertebrae

• 20 rings
• increases strength of disc, improves resistance to torsion, ensures some fibers of annulus will be taught with any movement
• outer zone: fibrocartilage (Sharpey's fibers) attach peripheral part of vertebral body
• intermediate zone: fibrocartilage
• innerzone: fibrocartilage, large number of cartilage cells

1. hydrophilic mucoid tissue:

high water binding capacity, disc is composed of 85-90% water

2. mucopolysaccarides

allow disc to act as an incompressible fluid, decrease with age and are replaced by collagen

1. permit, guide, and limit invertebral motion

facet joints providde 40% of torsional and shear strength of spine

2. in cases where interposed disc is not healthy the facet joints may carry up to 70% of axial load

1. pedicle of superior vertebrae: roof

2. pedicle of inferior vertebrae: floor

2. inferior articular process of superior vertebrae: post wall

3. superior artciualr process of inferior vertebrae: post

4. posterolateral margins of vertebral bodies and IVD: anterior wall

1. perioheral posterior aspect of annulus fibrosis: sinuvertebral nerve

2. peripheral lateral aspect of annulus fibrosus

3. anterior longitudinal ligament

4. posterior longitudinal ligament

5. vertebral body

6. nerve roots

7. facet joint cartilage